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TAMARA TANNER
NPI 1053706937
Pediatrics - Pediatric Rheumatology in Bronx, NY

Active since March 30, 2015PECOS Enrolled
111 E 210TH ST, BRONX, NY 10467(718) 920-4321 Get Directions Write a Review

NPPES record last updated: August 26, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tamara Tanner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAMARA TANNER (NPI 1053706937) is an individual pediatric rheumatology provider in Bronx, New York, licensed in New York (289317) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053706937
Entity TypeIndividualFemale
Primary Taxonomy2080P0216X
Provider Legal NameTAMARA TANNER
Location Address111 E 210TH STBronx, NY 10467-2401
Mailing Address3415 Bainbridge AveBronx, NY 10467-2403 · (718) 741-2450
Phone(718) 920-4321
Sole ProprietorNo
Enumeration DateMarch 30, 2015
Last NPPES UpdateAugust 26, 2020
NPPES CertifiedAugust 26, 2020
✔ NPI 1053706937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0216X
License✔ Licensed in NY · 289317
Definition
A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
111 E 210TH ST, Bronx, NY 10467
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tamara Tanner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Tamara Tanner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Montefiore Medical Center
Same address
Anesthesiology
111 E 210TH ST
Bronx, NY 10467
  • Reassigned Medicare billing, New York enrollment
  • 5,251 clinicians in this Medicare group
NPI 1063525152 (914) 378-6021

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AMANDA MCNEAR JACOBS M.D.
Pediatrics (Adolescent Medicine)
111 E 210TH ST, DEPARTMENT OF PEDIATRICS
BRONX, NY 10467
Bronx County (718) 920-2306
HEATHER ROOT MD
Internal Medicine (Infectious Disease)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-8592
MICHAEL GOTTESMAN M.D.
Radiology (Diagnostic Neuroimaging)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-5506
JIAE LEE M.D.
Psychiatry & Neurology (Neurology)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
DR. MICHELLE DOMINIQUE PINTEA MD
Pediatrics
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
TELISHA MCLEAN
Nurse Practitioner (Family)
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
SHIVADITYA CHOUDHURY
Anesthesiology
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321
MS. JOHANNA SHEA-FEN TAN
Student in an Organized Health Care Education/Training Program
111 E 210TH ST
BRONX, NY 10467
Bronx County (718) 920-4321

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tamara Tanner's NPI number?

The NPI number for Tamara Tanner is 1053706937. It was assigned to this individual provider in the NPPES registry on March 30, 2015.

Where is Tamara Tanner located?

Tamara Tanner practices at 111 E 210th St, Bronx, NY 10467. The listed phone number is (718) 920-4321.

What is Tamara Tanner's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Rheumatology, with taxonomy code 2080P0216X.

Is Tamara Tanner enrolled in Medicare?

Yes. Tamara Tanner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tamara Tanner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tamara Tanner reassigns Medicare benefits to Montefiore Medical Center (Bronx, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tamara Tanner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tamara Tanner was last updated on August 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.